- Loomba, Rohit;
- Seguritan, Victor;
- Li, Weizhong;
- Long, Tao;
- Klitgord, Niels;
- Bhatt, Archana;
- Dulai, Parambir Singh;
- Caussy, Cyrielle;
- Bettencourt, Richele;
- Highlander, Sarah K;
- Jones, Marcus B;
- Sirlin, Claude B;
- Schnabl, Bernd;
- Brinkac, Lauren;
- Schork, Nicholas;
- Chen, Chi-Hua;
- Brenner, David A;
- Biggs, William;
- Yooseph, Shibu;
- Venter, J Craig;
- Nelson, Karen E
The presence of advanced fibrosis in nonalcoholic fatty liver disease (NAFLD) is the most important predictor of liver mortality. There are limited data on the diagnostic accuracy of gut microbiota-derived signature for predicting the presence of advanced fibrosis. In this prospective study, we characterized the gut microbiome compositions using whole-genome shotgun sequencing of DNA extracted from stool samples. This study included 86 uniquely well-characterized patients with biopsy-proven NAFLD, of which 72 had mild/moderate (stage 0-2 fibrosis) NAFLD, and 14 had advanced fibrosis (stage 3 or 4 fibrosis). We identified a set of 40 features (p < 0.006), which included 37 bacterial species that were used to construct a Random Forest classifier model to distinguish mild/moderate NAFLD from advanced fibrosis. The model had a robust diagnostic accuracy (AUC 0.936) for detecting advanced fibrosis. This study provides preliminary evidence for a fecal-microbiome-derived metagenomic signature to detect advanced fibrosis in NAFLD.